Do all employees need to enroll in the plan, or only the employees with children?
Please contact Priority Health if you are unsure of this. It is up to the group to make this determination, as it depends on how the medical carrier’s attestation form reads. Delta Dental will implement a group pediatric dental plan with no children enrolled, with only adults enrolled or with no one enrolled whatsoever.
Are there contribution and/or participation requirements for these pediatric dental plans?
No. Delta Dental does not have any contribution or participation requirements for our pediatric only dental plans.
How long are these rates good for?
The rates shown on the Pediatric EHB Certified Dental Plans benefit highlights form are guaranteed for any group plan with an effective date of 01/01/2020 through 12/01/2020.
Is a binder check required for a new group pediatric only dental plan?
No. We do not require a binder check for a new group pediatric only dental plan.
The enrollment form requires the employee to be the subscriber. Is this correct?
Yes. We cannot legally setup a contract with a minor, therefore, the employee (adult) is enrolled as the subscriber. Any dependents and spouses are enrolled under the employee’s coverage as such. We will not bill the group for any members enrolled over the maximum age of the contract. The group only gets billed for those dependents enrolled age 19 and under.
How long are dependents covered under this pediatric plan?
Dependents are covered until the end of the calendar year they turn 19. At that point, our system will automatically terminate coverage for the member.
How will I (the group) be billed?
The group pediatric dental plans are completely separate from Priority Health’s system. The contract is held directly with Delta Dental, therefore, using all applicable Delta Dental systems (no joint invoices with Priority Health). The group will be billed each month for the following month’s premium by Delta Dental.
Will members received ID cards?
No. Just like our standard dental plans, we do not issue ID cards to our members. When seeking services, the member must inform the provider’s office that he/she is with Delta Dental and then provide the employee’s Social Security number. Our providers have a secure online Toolkit (and phone number) they use to confirm coverage.